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Lung Reduction Surgery: The Procedure

Summary & Participants

What happens during lung reduction surgery? What should you do to prepare for it? Our panel of experts will take you through the process, from the months prior through the procedure itself. Video footage from an actual surgery will be shown.

Medically Reviewed On: May 07, 2008

Webcast Transcript

PAUL MONIZ: I'm Paul Moniz. Thank you for joining us on this webcast. Today we are talking about lung volume reduction surgery for chronic obstructive pulmonary disease, or COPD.

Lung reduction surgery can ease symptoms, but there is a stringent regimen you must follow before you'll even be considered for the surgery. Here to join us are two specialists who diagnose and operate on patients. The first is Dr. Byron Thomashow. He is a pulmonologist at New York Presbyterian Hospital, and a clinical professor of medicine at Columbia University. Welcome. We also have Dr. Michael Argenziano, who is a fellow in cardiothoracic surgery at New York Presbyterian Hospital.

Dr. Argenziano, let's begin with you. A lot of patients, and people who are watching this particular webcast may be wondering how this surgery differs from transplants, and specifically why transplants might not be a good option for someone suffering from COPD.

MICHAEL ARGENZIANO, MD: To begin, with respect to the differences between lung volume reduction surgery and transplantation, transplantation really only has been an option for a little over a decade now, and involves removal of the diseased lung or lungs, and replacement of those lungs with a donor lung or lungs from another person.

This involves immunosuppression, which is required. That is, medications which are required to prevent the patient from rejecting the new organs. Lung volume reduction surgery, on the other hand, involves removal of small parts of the diseased lung, in hopes of allowing other areas of the lung, which are perhaps less diseased, to function more efficiently, and therefore does not require any immunosuppression or addition of new medications. In fact, in many cases it allows patients to take less medication.

PAUL MONIZ: Why isn't a lung transplant a good option for some patients, especially patients that are in their sixties and seventies?

MICHAEL ARGENZIANO, MD: First of all, the main problem you have with any modality which involves transplantation, is donor supply. There are literally millions of people in this country that suffer from COPD, and there are hundreds of thousands that are probably candidates for a transplant. However, the number of organs is severely limited by the number of donors that are identified.

Specifically with respect to lung transplantation, the lungs are the organs, which are most delicate and which are most difficult to recover in good shape, or at least in good enough shape to be used for transplantation. Beyond that, as you've mentioned, COPD is a disease that strikes the elderly population. For that reason, because the immunosuppressive drugs that we use in transplantation can be problematic and even contraindicated in older patients, they are sometimes not a good combination. For that reason, most centers will not transplant patients that are older than 65 or 70 years of age.

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